Intraoperative cholangiography revisited

Arch Surg. 1992 Apr;127(4):448-50. doi: 10.1001/archsurg.1992.01420040094016.

Abstract

The charts of 1351 patients undergoing cholecystectomy at our institutions from 1985 through 1989 were reviewed retrospectively to evaluate the indications for and the success of intraoperative cholangiography. A total of 800 patients underwent intraoperative cholangiography. They were divided into two groups based on the absence (CR-) or presence (CR+) of clinical and/or operative criteria suggestive of the existence of common bile duct stones. Intraoperative cholangiography in CR- patients was of limited benefit, being negative (normal) in 95.7%, true-positive (abnormal) in 3.3%, and false-positive in 1%. False-positive intraoperative cholangiography resulted in unnecessary common bile duct explorations. Intraoperative cholangiography in CR+ patients proved useful, avoiding unnecessary common bile duct exploration in 55%. In those select CR+ patients with palpable common bile duct stones or cholangitis, little additional information was gained by the intraoperative cholangiography. We conclude that routine screening intraoperative cholangiography in CR- patients be reconsidered, as should the use of intraoperative cholangiography in CR+ patients with a palpable common bile duct stone or cholangitis. Intraoperative cholangiography in the remainder of CR+ patients proved beneficial and should be continued.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cholangiography*
  • Cholangitis / complications
  • Cholangitis / surgery
  • Cholecystectomy*
  • Cholecystitis / complications
  • Cholecystitis / surgery
  • Evaluation Studies as Topic
  • False Positive Reactions
  • Female
  • Gallstones / complications
  • Gallstones / diagnostic imaging*
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Pancreatitis / complications
  • Pancreatitis / surgery
  • Retrospective Studies